Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · May 2020
Meta AnalysisFull-endoscopic (bi-portal or uni-portal) versus microscopic lumbar decompression laminectomy in patients with spinal stenosis: systematic review and meta-analysis.
Lumbar stenosis causes pain in the lower lumbar spine and lower extremities and reduces the patient's quality of life and walking ability. Thus, these conditions are common surgical indications for spinal stenosis. Previous reports have shown satisfactory clinical outcomes of the full-endoscopic (FE) and MI technique decompressive laminectomy for lumbar stenosis. However, they still remain controversial. ⋯ III.
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Eur J Orthop Surg Tr · Apr 2020
Review Meta Analysis Comparative StudyBipolar versus monopolar hemiarthroplasty for displaced femur neck fractures: a meta-analysis study.
Hemiarthroplasty is commonly performed to treat femoral neck fractures. Still, there is a lack of consensus concerning the best component for hemiarthroplasty: unipolar and bipolar implants. Last meta-analysis on this topic is outdated, and an update of current evidences is required. The purpose of this study is to conduct a meta-analysis comparing the unipolar versus bipolar implants for hemiarthroplasty, focusing on the clinical scores, perioperative data, further complications and mortality rate. ⋯ This meta-analysis evidenced a reduction in the acetabular erosion after bipolar hemiarthroplasty compared to the unipolar implants. Any statistically significant difference concerning the other endpoints of interest was detected. Current evidence concerning this topic are controversial, and further randomized clinical trials are required.
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Eur J Orthop Surg Tr · Dec 2019
Meta Analysis Comparative StudyComparative outcomes between collared versus collarless and short versus long stem of direct anterior approach total hip arthroplasty: a systematic review and indirect meta-analysis.
Early research shows several advantages of the direct anterior approach (DAA) in THA that claimed to be as effective but less invasive than the posterior approach. However, due to the difficult femoral exposure and possible complications related to femoral preparation, this approach may result in a higher rate of undersized stems when compared to other approaches. The present authors believe that the femoral implant design (collar or collarless stem, short or long stem) in a collared femoral stem may relate to lower rates of stem subsidence and limb length discrepancy (LLD) in mid-term to long-term follow-up when compared to collarless femoral stems. However, currently, there is no consensus as to which femoral implant design is the most suitable for DAA in THA. ⋯ In DAA THA, collared femoral stem and long femoral stem had decreased complication rates when compared to collarless femoral stem and short femoral stem by both direct and indirect meta-analysis methods. However, in terms of revision rates, there were no differences between all femoral stems (short versus long and collared versus collarless). Prospective randomized controlled studies are needed to confirm these findings as the current literature is still insufficient.
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Eur J Orthop Surg Tr · May 2019
Meta AnalysisHemiarthroplasty for neck of femur fractures: to cement or not? A systematic review of literature and meta-analysis.
Management of fractures of neck of femur in the elderly is largely joint sacrificing, with hemiarthroplasties being the most common entity used. Cemented and uncemented, both the techniques, are universally accepted; however, the former has been more time tested, despite its theoretical disadvantage in the form of cement embolism leading to intra-operative complications. Uncemented stems have been ever evolving with newer designs to increase incorporation, stability and durability. They have their own reported sets of disadvantages like subsidence and fractures. However, overall there is no established gold standard out of the two. ⋯ Cementing techniques are here to stay, until a better, durable and more stable uncemented stem evolves, that could lessen the complications related to uncemented surgeries and match the cemented implants in pain relief and ambulation.
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Eur J Orthop Surg Tr · May 2019
Meta Analysis Comparative StudyUnicompartmental versus total knee arthroplasty for knee osteoarthritis.
In the last couple of years, a significant amount of studies comparing the UKA and TKA for unicompartmental knee osteoarthritis have been published. However, there is a lack of recent meta-analysis comparing the two implants. Since the number of performed UKAs is currently increasing and the indications are obsolete, it becomes important to update current evidences and outcomes. With these premises, a meta-analysis of clinical trials comparing UKA versus TKA was conducted. ⋯ The main findings of this meta-analysis are that UKA reported a reduced survivorship but better clinical and functional performances compared to TKA. Furthermore, shorter surgical duration, lower total estimated blood loss and quicker hospitalization length were observed in the UKA cohort.